Time is money

Interesting study from Vanderbilt University.  Paying physicians to take more time with patients.  I guess it would make sense if there was a correlation between improved patient outcomes and the length of the visit.  

A small number of physicians at Vanderbilt University Medical Center, Nashville, are taking part in a study to find out if it's more cost effective in the long run to pay doctors to take more ...

Read more...

. . . with a Pfizer rep yesterday led to their new medication, Caduet.  This is simply a combination of Pfizer's best-selling medications, Norvasc and Lipitor.  I was commenting on how this medication is convenient for those concurrently taking the two medications separately.  Then, to my surprise the rep suggested that I use this first-line for hypertension, saying that "people with hypertension have high cholesterol anyways". 
 
Pretty ...

Read more...

So not everyone's happy about the new NCEP cholesterol guidelines.  Drug companies funding studies is absolutely nothing new.  In this case, the data is sound and peer-reviewed.  True, it's not a completely ideal source of funds, but the money's got to come from somewhere.  

So, I was browsing the headlines and caught this story from Romania.  A bad time and place for your surgeon to lose it.

As health plans trend towards a deductible-type insurance, more patients will have to shoulder the cost. To that end, some health plans in Massachusetts are posting costs of various tests on the web.

Patients being more aware of the cost of care, and being able to talk about cost with doctors, is generally "a good thing and desirable," said James F.X. Kenealy, MD, an otolaryngologist in Framingham, ...

Read more...

As many may know, Medlogs is an indispensible aggregator of medical blogs. Lately, there was concern about how many non-medical blogs were included in the physician section. Let me say that I completely agree and applaud the recent editorial changes at the site. Thanks Nick for saying what has been on everyone's minds. Medlogs is now much cleaner and more medically relevant.

As ...

Read more...

Innocent

Everyone was acquitted in the local case against TAP Pharmaceuticals, charging that the drug reps were bribing physicians to prescribe their drugs (Lupron and Prevacid). Although certainly in a moral gray zone, tough to say that it was criminal.

. . . on a fertility case gone wrong due to a medical mix-up.

Some big changes in the coming months. First we're switching to an EMR. After that, there's the increasing pressure by management to see more patients - not to mention having our compensation structure more directly correlate with our productivity RVUs. I'm thinking of changing my schedule structure - currently it's the standard 15-minute blocks with 30-minute physicals. Many advocate the modified-wave structure. Looks good ...

Read more...

As you may have heard, the new NCEP cholesterol guidelines were released yesterday. The biggest change is a goal LDL of < 70 in the very high risk group. Now, what classifies as very high risk? They are the following:

Established CAD plus:
i) multiple major risk factors (esp. diabetes)
ii) severe and poorly controlled risk factors (i.e. continued smoking)
iii) multiple risk factors of ...

Read more...

As you may heard, in Lowell, MA this lady recently won the $294 million MegaMillions jackpot. Some psychologists say that the so-called sudden wealth syndrome often leads to impulse buying and social isolation.

Two views . . .

. . . on medical malpractice. One from the insurers' perspective, the other from the lawyers. These articles are from the state of Wyoming, where 1 of the 3 medical malpractice insurers withdraws from the state later this year.

. . . as a solution to alleviate the malpractice crisis. Some practices claim up to 80% of patients agree to the terms - namely waiving their right to a jury trial. Read more about it in Medical Economics.

Medrants and RangelMD have chimed in with their opinions on the piece regarding the patient who demanded ovarian-cancer screening. Each makes fantastic points.

Also, in response to BMC hiring a managment consultant, symtym supports the idea, while Blogborygmi takes a more cautious take.

Medpundit links to an excellent article detailing how more cancer screening isn't necessarily better. There certainly should be further public education on taking a more balanced, evidence-influenced view - or else more physicians would be subjected to this.

This story is getting a lot of play here. Here are the basics:

In short, the unsupervised pharmacy technician, in her second week on the job, wrongly added insulin to an undisclosed number of intravenous nutrient bags prescribed to sick infants.

The feeding bags contained no indication of insulin on their labels. They apparently were not checked by the pharmacist before delivery to the neonatal intensive ...

Read more...

Medrants has recently ranted about going to back to basics:

We need to return to first principles. The reason we became physicians was to care for people, not patients! By that I mean, caring for the patient, rather than the disease.

We need a revolution in our thinking. This revolution actually is occuring in retainer practices and cash only practices. Patients will, I believe, be willing to pay ...

Read more...

Nothing like reading an article about my old training ground, Boston Medical Center. Having the state's busiest emergency room gave them incentive to decrease waiting times, especially in light of the recent stories about other ER's in the state. They brought in a management consultant, and instituted some radical ideas. So far, seems pretty successful.

So, I saw a woman in her 40's this morning who demanded to be screened for ovarian cancer. Knowing that no governing body recommends this, I had a long discussion regarding the risks and benefits of screening for ovarian cancer. Then came the line: "It is my right to demand this test, if you won't, I'll sue the clinic". Nice. Thoughts of this story came ...

Read more...

. . . why we need universal health coverage. Sounds like beating a dead horse. This Boston Globe story just details how increasing numbers of hard-working families simple cannot afford insurance.

Most Popular

Get KevinMD's 5 most popular stories.